CT STAGING IN 150 CASES OF LOWER-LIMB LYMPHEDEMA

The aim of this work was to evaluate the usefulness of CT imaging to s tage lower limb lymphedemas. Between 1992 and 1997, we studied 150 cas es of lymphedema, half idiopathic and half secondary. Methods used are described. In decreasing order of frequency, we found. skin thickenin g, increased subcutaneous tissue surface area compared with the health y limb, thickening of the perimuscular aponevrosis, fat infiltration: lines parallel to the skin (//), edematous areas along the perimuscula r aponevrosis, lines perpendicular to the skin (perpendicular to). The lowest fat density was increased on the diseased side. The subfascial tissue showed some fat accumulation. These results were compared with findings reported in the literature. There were very major difference s between idiopathic lymphedema and secondary lymphedema of the thigh. Similar images were generally generated by new and long-standing lymp hedema. Rarely useful for positive diagnosis, CT is indispensable for establishing stage initially or after recent increase and, in our opin ion, is essential for pretherapeutic assessment. The CT-scan gives obj ective evidence of overall disorders, the exact upper limit of the lym phedema, and sometimes reveals infraclinical bilateral involvement.